Interpersonal Approaches to Mental Health Notes PDF

UNIT -2 **[INTERPERSONAL APPROACHES TO MENTAL HEALTH]** **[Interpersonal approach --]** The interpersonal approach is a unique approach to individual therapy, which integrates a individual's relational experiences and their thoughts about themselves and their experiences to bring an about an awar...

UNIT -2 **[INTERPERSONAL APPROACHES TO MENTAL HEALTH]** **[Interpersonal approach --]** The interpersonal approach is a unique approach to individual therapy, which integrates a individual's relational experiences and their thoughts about themselves and their experiences to bring an about an awareness of how these domains impact once's circumstances. Through our life experiences, we all come to develop coping style, or ways that we learn how to relate to others. Such coping types may include pleasing and accommodating others to avoid disagreement or conflict, exerting control over others through aggressive resistance, or even. Physical avoidance, emotional withdrawal and self- sufficiency. In many instances, these coping styles may become maladaptive, or rigidly applied, which can cause relationship problems stress and stress **[Communication ]** Communication is a means of persuasion to influence the other so that the desired effect is achieved "Aristotle" Communication is the process by which two or more people exchange ideas, facts, feelings or impressions in ways that each gains a common understanding of meaning, intent and use of a message" **[Importance of communication --]** We all have a strong need for connectivity and belonging. This is why positive social interactions increase our [subjective-wellbeing](https://positivepsychology.com/subjective-well-being/) and provide greater life satisfaction (Lyubomirsky, 2008). A communication model usually involves a sender, a receiver, and a (verbal or nonverbal) message which is encoded by the sender and decoded by the receiver. It also includes feedback, the response of the receiver to the message, as well as noise, which is anything that can disrupt communication. Encoding refers to the sender transforming thoughts into communicable messages. The receiver interprets what they receive as the message---both verbal and nonverbal parts. Although this seems simple in theory, as you can imagine a lot happens in between and no message is ever decoded without bias. **[Interpersonal communication --]** The basic process of communication begins when a fact is observed or an idea formulated by one person. That person (the sender) decides to translate the observation into a message, and then transmits the message through some communication medium to another person (the receiver). The receiver then must interpret the message and provide feedback to the sender indicating that the message has been understood and appropriate action taken. Unfortunately, errors can be introduced during any phase of the communication process. For example, misunderstandings can occur when the sender does not possess a clear idea of the message he or she is trying to communicate, or has a clear idea but is not able to express it well. Errors in the process can also occur when the receiver does not listen carefully, infers a different meaning than what was intended by the sender, or fails to provide feedback. Ultimately, unclear, inaccurate, or inconsiderate business communication can waste valuable time, alienate employees or customers, and destroy goodwill toward management or the overall business. **[TYPES ]** ### **Controlling** The controlling style is a form of one-way communication that is used to direct others and gain their compliance. Managers using this style usually do not want feedback, and they tend to employ power and even manipulation to reinforce their message. Although the controlling style can be effective when it is used on occasion by respected individuals, particularly in times of crisis, it can also alienate workers. ### **Egalitarian** In contrast, the egalitarian style is a form two-way communication that involves sharing information rather than directing behaviour. It is used to stimulate others to express their ideas and opinions in order to reach a mutual understanding. In most situations---particularly when cooperation is needed---it is more effective than the controlling style. ### **Structuring** The structuring style of interpersonal communication is used to establish schedules or impose organization. Managers using this style would be likely to cite company standards or rules. Though the structuring style may be necessary to inform others of goals or procedures when complex tasks must be performed by a group, it should usually be counterbalanced with the egalitarian style. ### **Dynamic** The dynamic style is a high-energy approach that uses inspirational pleas to motivate another person to take action. This style can be effective in crisis situations, but it is generally ineffective when the receivers do not have enough knowledge or experience to take the required action. ### **Relinquishing** The relinquishing style of interpersonal communication is deferential rather than directive. It is highly receptive to the ideas of others, to the point of shifting responsibility for communication to the receiver. For example, a manger employing this style might allow her staff to discuss and develop the final solution to a problem while making little comment. This style is particularly effective when the receivers have the knowledge, experience, and willingness to assume responsibility. ### **Withdrawal** The withdrawal style is more like a lack of communication. Managers using this style try to avoid using their influence and may indicate a disinterest or unwillingness to participate in the discussion. **[How to better communication ]** It is based on the willingness and the ability to approach and perceive issues in a non-judgmental way. This is important because whenever you want to change someone, you will create resistance. #### **1.** **Observation ≠ Interpretation/Evaluation** Firstly, try to communicate your observations without labelling or interpreting them. In the case of your date arriving late, it is just that: he is late. Your interpretation may be that the date (or you) doesn't mean a great deal to him or that something else was more important. So rather than buying into your interpretation, you could simply say "I realize you were late for our date". This is a factual observation without any evaluation. #### **2. Feelings ≠ Thoughts** Secondly, it is important that you communicate your feelings. An argument often develops from hidden emotions. Make sure you understand your emotions and express them in a non-judgmental way. In the case of a late arrival of your date, you could say "I am feeling annoyed", or "I am bothered by this because it makes me wonder whether you are looking forward to spending time with me". #### **3. Need ≠ Strategy** Thirdly, you need to understand and express your needs. In doing so, you give your partner the chance to decide whether they can and want to meet them. For instance, you could say: "I would like to be treated with consideration and I would like to feel important to you". #### **4. Request ≠ Demand** The fourth step is to make a clear request. What does your partner have to do for you to feel that your needs have been met? You could simply say: "That is why I ask you to arrive at the agreed time". **[Interpersonal Conflicts --]** Interpersonal conflict occurs in interactions where there are real or perceived incompatible goals, scarce resources, or opposing viewpoints. Interpersonal conflict may be expressed verbally or nonverbally along a continuum ranging from a nearly imperceptible cold shoulder to a very obvious blowout. Interpersonal conflict is, however, distinct from interpersonal violence, which goes beyond communication to include abuse. The five conflict management styles all have the goal of bringing the involved parties to a resolution. They just have different ways of getting there. Each style exhibit different levels of cooperativeness and assertiveness. ### **Accommodating** An accommodating conflict management style is used when you set aside your own wants or needs and focus on those of others. You leave your own concerns behind and accommodate for those of someone else. ### **Avoiding** An avoiding conflict management style ignores the situation altogether. Either one or both of the people involved in the conflict steer clear of it. ### **Compromising** A compromising conflict management style tries to find a way to partially satisfy people on both sides of the argument. Adjustments are made on both ends to resolve the conflict at hand. ### **Collaborating** A collaborating style includes finding a solution that will completely appease all involved parties. A win-win situation, if you will. ### **Competing** A competing style is for all you headstrong folks. With this approach, you take a firm stance and refuse to budge until you get what you want. You are unmoved by the perspectives of the other parties involved in the conflict. **Non-- Violence Communication** Nonviolent communication (NVC), sometimes referred to as compassionate communication, is an approach to communicating designed to help people connect more [compassionately](https://www.goodtherapy.org/blog/psychpedia/definition-of-compassion) with themselves and others. Nonviolent communication can transform interactions, as it enables people to become more aware of their [feelings](https://www.goodtherapy.org/blog/psychpedia/emotion), needs, and desires, as well as those of others, in a given situation. **The Goal of Non-Violent communication** The focus of nonviolent communication is to help people rethink and restructure the way in which they express themselves and listen to others. As humans, we learn to respond to certain situations in an automatic manner. When asked \"How are you?\" for example, the automatic response might be \"I\'m fine,\" although this might be far from the truth. **[The Process of nonviolent communication ]** The process of NVC involves four key components: - - - - - First, individuals observe what is happening in a given situation without any form of judgment. Next, they express how these observations make them feel and what needs, values, or desires are related to these feelings. Finally, they make clear, specific requests based on what they need to enrich their lives, instead of demanding these from others. For example, a wife whose husband shouted at her at a social function might express these four components by saying, \"When you shout at me in public (observation) I feel humiliated (feeling) because I value respect, especially in the presence of others (need). When we have a disagreement in public, would you be willing to wait until we can discuss the matter in private (request)?\" - Since communication is a two-way street, the process would not be complete unless both people are willing to accept the same four pieces of information from each other. That is, they must discern what others are observing, feeling, and needing, without evaluating, and they must be open to receiving their requests. The four components of nonviolent communication need not be expressed in the same order each time. The process allows for some creativity so that the verbal exchange does not become mechanical and formulaic.   [The Four Horsemen ] ================================ The Four Horsemen of the Apocalypse is a metaphor describing the end of times in the New Testament.  Relationship experts, Drs. John and Julie Gottman, use this metaphor to describe communication styles that often predict the end of a relationship.  Through four decades of research, working with more than 3,000 couples, the Gottman's have also created a series of antidotes to battle the four horsemen.  We know that all couples encounter stress and conflict, but research shows that the success of a marriage is less about the appearance and severity of relational concerns and more about the *management* of the concerns.  Some problems will remain unsolvable due to personality differences, but the marriage can still thrive with acceptance and healthy communication.  If you work with me, you will often hear me say, "be curious about your partner."  When we remain open-minded to our partner's perspective, conflict can actually be a tool for growth and understanding.     ### **[1. Criticism ]** The first horseman in communication is criticism.  Think about how often we are exposed to criticism today.  Our bosses criticize us when our work is not up to par.  Our parents criticize us when making decisions that do not align with their expectations.  We even criticize ourselves when exposed to all the "right ways of doing things" on social media.  It makes total sense that this criticism rolls naturally into our relationships.    It is important to speak up and let your partner know how you are feeling, so complaints are very much accepted.  Communication becomes unhealthy and damaging when you are verbally attacking your partner's personality or character, rather than letting them know how you feel.  This is why incorporating a gentle start-up that focuses on your needs and emotions is the antidote to criticism.  Try to start the sentence with "I feel," and avoid starting with "you."  *Criticism: "You never think about spending time with me.  You are always working and care more about your boss and co-workers than me." * *Gentle Start Up: "I feel unsupported and lonely since you have been spending extra hours at work.  I miss our date nights.  Can we plan one this weekend?" * ### **[2. Contempt]** The second horseman is contempt.  I like to think of this one as criticism times ten.  We are still attacking our partner, but this time, we are really degrading our partner's worth.  We attack their sense of self with the intent to abuse.  Contempt is brewed over time with a long series of negative thoughts that are not resolved in the moment.  I have seen this one happen as an attempt to feel heard.  One partner is trying to share an important message, but it is lost in translation because the receiver is emotionally abused.  Contempt is the single biggest predictor of divorce and needs to be avoided to ensure success of a relationship.  The antidote is building a culture of appreciation.  Remind yourself of your partner's positive qualities and find gratitude for all the things they ARE doing right.  Think about why you fell in love with this person.  Consider the strengths that remain in your relationship despite all the changes. *Contempt: "Did you really just leave your dish in the sink after I cleaned the kitchen?  Could you be any lazier?   You can't do anything right these days.  It's pathetic." * *Build Culture of Appreciation: "I know you have been working extra hours lately and I bet you are exhausted.  I love how you are always focused on providing for our family.  It would be helpful if you can help me get those dishes out of the way so we can relax together tonight."    *   ### [**3. Defensiveness         ** ] The third horseman is defensiveness.  When we interpret a message as criticism, our nervous system fights to protect our emotional safety.  This is why we often become defensive when our partner tells us we are doing something wrong.  We don't want to face the negative emotions that come with acceptance of hurting our partner or not doing enough at home.  So instead, we deny the blame.  Sometimes we victimize ourselves and provide an excuse for the behavior.  Other times, we find it easier to reverse the blame and remind our partners of their shortcomings. The antidote for defensiveness is taking responsibility.  I like to remind clients that taking responsibility doesn't mean being completely submissive and accepting all blame.  It just means that you accept your partner's perspective and offer an apology if needed.  In session, I use the words, "try to make sense of your partner's world."  I joke that clients get bonus points if they can even make a connection between their partner's current emotions and a similar emotion they have experienced in the past.  If you are able to validate your partner's perspective and take responsibility for at least one small thing, your thoughts and feelings are much more likely to be heard.  Everyone wins.    *Defensiveness: "I can't take you out for dinner tonight.  I have too much to get done for work.  You could have reminded me about our plans earlier or tried to help with the chores, so I could have gotten my other work done earlier."      * *Taking Responsibility: "I recognize that you gave me a week's notice about our date night and felt hurt when I bailed.  I procrastinated on this important project for work and I didn't make you a priority this time."*   ### **4. Stonewalling** The last of these horsemen is stonewalling.  This happens when someone becomes conflict-avoidant and withdraws completely from the conversation.  They emotionally shut down and stop responding which often creates an immediate need for distance and separation.  Stonewalling occurs the most in response to contempt.  Their partner took the fight too far and the only weapon left in their arsenal is a big, "just leave me alone" wall.   Sometimes when we stonewall, we become physiologically flooded and are incapable of rationally processing emotions.  This is why physiological self-soothing is the antidote to stonewalling.  It is important to take a break and do something that is calming and distracting from the emotional wounds.  Try deep belly breathing, watching a funny tv show, or taking a hot shower.  The advice I give clients is to also set a time to come back and address the words that led to stonewalling, rather than just walking away.  This is a scary situation for the person that stonewalled.  They need to be brave and vulnerable with someone that hurt them.  When re-visiting the topic, the worst thing their partner can do is reject their emotions.  The best thing they can do is accept responsibility for the abuse and communicate their own feelings in a gentle way. *Stonewalling: "I am done talking about this."* *Physiological Self-Soothing: "I am feeling really hurt right now and need to take some time to myself.  Can we talk again over dinner tonight?" * **[10 Cognitive Distortions ]** **All-or-Nothing Thinking** --------------------------- An example of all-or-nothing thinking is dwelling on mistakes and assuming you will never be able to do well, instead of acknowledging the error and trying to move past it. One way to overtime this cognitive distortion is to recognize that success and progress are not all-or-nothing concepts. By addressing this type of thinking and replacing self-defeating thoughts, you can feel better about your progress and recognize your strengths. **[Overgeneralization]** ------------------------------------ [Overgeneralization](https://www.verywellmind.com/overgeneralization-3024614) happens when you make a rule after a single event or a series of coincidences. The words \"always\" or \"never\" frequently appear in the sentence. Because you have experience with one event playing out a certain way, you assume that all future events will have the same outcome. For example, imagine that you made a suggestion about a work project that wasn\'t adopted in the final work. one might overgeneralize this and assume that no one at work ever listens to you or takes you seriously. One way to combat overgeneralization is to focus on using realistic language. Instead of saying "I always do that" say something such as, "That happens sometimes, but I'll try to do better next time." -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- **Mental Filters** ------------------ A [mental filter](https://www.verywellmind.com/mental-filters-and-panic-disorder-2584186) is the opposite of overgeneralization, but with the same negative outcome. Instead of taking one small event and generalizing it inappropriately, the mental filter takes one small event and focuses on it exclusively, filtering out anything else. For example, Nathan focuses on all of the negative or hurtful things that his partner has said or done in their relationship, but he filters all the kind and thoughtful things his partner does. This thinking contributes to feelings of negativity about his partner and their relationship. [Journaling](https://www.verywellmind.com/the-benefits-of-journaling-for-stress-management-3144611) is one strategy that might help overcome mental filtering. Make an effort to intentionally shift your focus from the negative and look for more neutral or positive aspects of a situation.  **Discounting the Positive** ---------------------------- Discounting the positive is a cognitive distortion that involves ignoring or invalidating good things that have happened to you.^4^ It is similar to mental filtering, but instead of simply ignoring the positives, you are actively rejecting them. For example, Joel completes a project and receives an award for his outstanding work. Rather than feeling proud of his achievement, he attributes it to pure luck that has nothing to do with his talent and effort. One way to overcome this cognitive distortion is to reframe how you attribute events. Instead of seeing positive outcomes as flukes, focus on noticing how your own strengths, skills, and efforts contributed to the outcome. **Jumping to Conclusions** -------------------------- There are two ways of jumping to conclusions: - Mind reading: When you think someone is going to react in a particular way, or you believe someone is thinking things that they aren\'t - Fortune telling: When you predict events will unfold in a particular way, often to avoid trying something difficult For example, Jamie believes that he cannot stand life without heroin. Such beliefs hold him back from getting the treatment and help that he needs to successfully recover from substance use. To overcome this cognitive distortion, take a moment to consider the facts before you make a decisions. Ask questions and challenge your initial assumptions.   **Magnification** ----------------- [Magnification](https://www.verywellmind.com/magnification-and-minimization-2584183) is exaggerating the importance of shortcomings and problems while minimizing the importance of desirable qualities. Similar to mental filtering and discounting the positive, this cognitive distortion involves magnifying your negative qualities while minimizing your positive ones.  For example, when something bad happens, you see this as \"proof\" of your own failures. But when good things happen, you minimize their importance. For example, a person addicted to pain medication might magnify the importance of eliminating all pain and exaggerate how unbearable their pain is. To overcome magnification, focus on learning how to identify these thoughts and intentionally replacing them with more helpful, realistic ways of thinking. **Emotional Reasoning** ----------------------- Emotional reasoning is a way of judging yourself or your circumstances based on your emotions. This type of reasoning assumes that because you are experiencing a negative emotion, it must accurately reflect reality. If you feel experience feelings of guilt, for example, emotional reasoning would lead you to conclude that you are a bad person. For instance, Jenna used emotional reasoning to conclude that she was a worthless person, which in turn led to [binge eating](https://www.verywellmind.com/diagnostic-criteria-for-binge-eating-disorder-1138164). While research has found that this distortion is common in people who have anxiety and depression, it is actually a very common way of thinking that many people engage in.^5^ Cognitive behaviour therapy can help people recognize the signs of emotional reasoning and realize that feelings are not facts. \"**Should\" Statements** ------------------------- [\"Should\" statements](https://www.verywellmind.com/should-statements-2584193) involve always thinking about things that you think you \"should\" or \"must\" do. These types of statements can make you feel worried or anxious. They can also cause you to experience guilt or a sense of failure. Because you always think you \"should\" be doing something, you end up feeling as if you are constantly failing. An example: Cheryl thinks she should be able to play a song on her violin without making any mistakes. When she does make mistakes, she feels angry and upset with herself. As a result, she starts to avoid practicing her violin. **Labelling** ------------- Labelling is a cognitive distortion that involves making a judgment about yourself or someone else as a person, rather than seeing the behaviour as something the person did that doesn\'t define them as an individual. For example, you might label yourself as a failure. You can also label other people as well. You might decide that someone is a jerk because of one interaction and continue to judge them in all future interactions through that lens with no room for redemption. **Personalization and Blame** ----------------------------- Personalization and blame is a cognitive distortion whereby you entirely blame yourself, or someone else, for a situation that, in reality, involved many factors that were out of your control. For example, Anna blamed herself for her daughter\'s bad grade in school. Instead of trying to find out why her daughter is struggling and exploring ways to help, Anna assumes it is a sign that she is a bad mother. **Coping With Cognitive Distortions** ------------------------------------- Once one recognize that one is experiencing cognitive distortions, there are steps that can taken to change these ways of thinking. Getting help is important, because these distorted thought patterns can seriously affect mental health and well-being. To change cognitive distortions: ### **Become More Aware of Your Thoughts** Try to notice the thoughts that contribute to feelings of anxiety, negativity, or depression. Practices such as journaling and mindfulness may help you build better awareness of your own thoughts. ### **Recognize the Effect of Cognitive Distortions** Cognitive distortions can contribute to poor decisions making, but they can also play a significant role in the onset and maintenance of mental illness and other issues. Such distortions are associated with the following: - Addiction - Anxiety, fear, and panic - [Borderline personality disorder (BPD)](https://www.verywellmind.com/what-is-borderline-personality-disorder-bpd-425487) - Depression - Feelings of hopelessness - Increased risk of suicidal thinking - Low self-esteem - [Narcissistic personality disorder (NPD)](https://www.verywellmind.com/what-is-narcissistic-personality-disorder-2795446) - Poor self-efficacy - [Post-traumatic stress disorder (PTSD)](https://www.verywellmind.com/requirements-for-ptsd-diagnosis-2797637)